The Importance of Early Detection: A Conversation with a Urologist about Prostate Cancer

In this video, urologist Dr. Baruchem discusses the importance of early detection for prostate cancer. He explains that prostate cancer often presents with no symptoms, so testing is necessary to identify it. The two main tests for early detection are the PSA blood test and a digital rectal exam. Dr. Baruchem emphasizes that the rectal exam is a quick and important part of the screening process, despite the misconception some men have about it. He recommends that men over 50 should have annual testing, while black men and those with a family history should consider earlier screening. Dr. Baruchem also clarifies that an enlarged prostate does not indicate an increased risk of prostate cancer. He concludes by urging men to be vigilant about their health and for their loved ones to support them in getting screened.

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Key Insights:

  • Prostate cancer often presents with no symptoms, so testing is crucial for early detection.
  • The two main tests for prostate cancer detection are the PSA blood test and the digital rectal exam.
  • There is no need to be apprehensive about the rectal exam as it only takes three seconds and can save lives.
  • The location of the prostate makes the rectal exam the easiest point for urologists to feel for abnormalities.
  • The PSA test detects a specific protein made by the prostate, and a level above 4 is considered abnormal.
  • The PSA test and rectal exam should be part of a man’s annual physical, especially for those with a family history of prostate cancer.
  • Prostate cancer tends to run silent without symptoms, but urinary complaints should still be evaluated.
  • An enlarged prostate does not indicate prostate cancer or increase the risk of it.
  • The stages of prostate cancer range from organ-confined disease to locally advanced cancer and distant spread.
  • Treatment options for prostate cancer include surgery, radiation therapy, hormone therapies, and chemotherapy.
  • Black men have a higher rate of prostate cancer, so early screening is crucial for early intervention and potential cure.
  • Partners should be supportive and encourage their loved ones to get regular prostate cancer screenings.


What’s up everybody, I’m Renata, and we’re here with urologist Dr. Baruchem. He is here to talk to us about prostate cancer because knowing the basics in life saves lives, right doc?


Okay, doc, what should men know when it comes to early detection of prostate cancer?

One of the things that we’ve learned about prostate cancer is that very often, it presents with no symptoms. So, it’s one of those things that you have to test for to figure it out. The testing consists of two main things. One is a blood test called a PSA test, and the other is a simple digital exam where a finger is inserted inside through the backside to examine the prostate for about three seconds.

And that’s why men don’t like to do the prostate cancer exam, right?

There are two elements to that. Firstly, it’s really not a big deal. It’s just a three-second exam where the finger goes inside for a medical examination. It has nothing to do with manliness or manhood. Secondly, if someone refuses the rectal exam, the blood test can still go a long way in detecting prostate cancer. So, it’s worth having a conversation with your doctor.

Great. So, can we talk about the location of the prostate? Since you have to go that route to detect it.

If you think about the urinary system, you have the kidneys at the top, which lead to the ureters, then connecting to the bladder. The bladder has a small channel called the urethra. The prostate surrounds the urethra, internally to the pubic bone. The rectal examination is done because it is the easiest way for us to feel the prostate.

Alright. What exactly does the PSA test detect, and why is it so crucial?

PSA is a blood test that detects a protein produced by the prostate. All prostates produce PSA, whether they are cancerous or non-cancerous. As urologists, we need to determine the significance of the PSA level in each individual. Generally, PSAs above four are considered abnormal, while PSAs below four are considered normal. Abnormal PSA tests or abnormal rectal examinations may indicate the need for further testing to determine if there is potential cancer.

Should the PSA test be a part of a man’s annual physical, or how often should they get their PSA levels checked?

The PSA test should be a part of the annual physical. It’s important to note that many primary care physicians are no longer doing PSA testing or rectal examinations. Men should be proactive in seeking prostate cancer screenings and should challenge their doctors if necessary. Rectal examinations can be uncomfortable, but they should still be requested. Generally, in the average population, men over 50 should get tested annually. For black men, screening should start around age 45, and men with a strong family history of prostate cancer should consider earlier screening.

Are there any other warning signs men should be aware of besides the PSA test?

Unfortunately, prostate cancer tends to be silent unless detected early or in more advanced stages. Symptoms such as bone pain, weight loss, and urinary complaints may indicate advanced prostate cancer. However, urinary complaints are often caused by benign conditions rather than cancer.

What about an enlarged prostate? Is that a warning sign or could it increase the risk of prostate cancer?

An enlarged prostate, in most cases, is nothing abnormal or unusual in men. It doesn’t indicate prostate cancer, nor does it increase the risk of prostate cancer. It may cause urinary complaints due to the obstruction of urinary flow, but it is not a sign of cancer.

Moving back to prostate cancer, can you break down the different stages?

Prostate cancer can be classified into organ-confined disease, which is more localized and identified at an early stage. Then there is locally advanced cancer, which has spread to nearby organs but hasn’t metastasized. Finally, there is distant disease where cancer has spread to lymph nodes or other sites, such as the bone or liver. Treatment options depend on the stage of cancer, the patient’s age, and their overall health conditions. Treatment modalities include surgery, radiation therapy, hormone therapies, and chemotherapy.

Black men have higher rates of getting prostate cancer. What do they and the women in their lives need to know?

There is a genetic predisposition that makes men of black origin more prone to prostate cancer. The higher rates of prostate cancer in black men occur at an earlier age and tend to be more aggressive. Starting the screening process earlier can be beneficial, as detecting prostate cancer at an early stage improves the chances of a cure. Partners should be supportive and help alleviate fears and misconceptions about screening. Encouraging regular exams and open communication is essential for early detection.